Health Insurance Portability: Benefits and Steps of Health Insurance Portability

What is Health Insurance Portability? Health insurance portability enables you to transfer your health insurance policy from one insurer to another without losing benefits, such as waiting or moratorium periods. You can port only at renewal, and the new insurer must honor credit earned under the old policy. Portability ensures flexibility for policyholders who are dissatisfied with the service, premiums, or coverage. Although regulated by IRDAI, it is not a right and depends on the new insurer’s underwriting policy.

What if you could switch to a better health insurance plan without losing any of the benefits you've already built up? Health insurance portability makes this possible. It’s a game-changer for those who want flexibility in their health coverage but are hesitant to give up the perks they've earned. But before you start switching plans, there are some key things you should know to make the process seamless. Let’s dive into the essentials.

What Is Health Insurance Portability?

Health insurance portability allows you to transfer your health insurance policy from one insurer to another. The best part? You don't have to lose any benefits you’ve earned, including the waiting period you’ve served or any accumulated bonuses. This makes it instrumental if you're not satisfied with your current plan and want to switch to a more cost-effective or comprehensive coverage.

Let’s understand this better with the help of an example.

SIM Card Porting Example:

Think of it like switching mobile network providers but keeping your same phone number. When you switch to a new provider, you don’t lose your number, and all your old call history, data, and contacts are still intact (assuming your phone is compatible with the new network).

Similarly, when you port your health insurance policy, you can switch to a new insurer without losing any of the benefits, like the waiting periods for pre-existing conditions or any bonuses that you've accumulated, provided the policy is transferred according to guidelines.

Note: The no-claim bonus or cumulative bonus itself is not carried forward. However, if the policyholder opts for a higher Sum Insured while porting, the new insurer may waive waiting periods served to the extent of the previous plan’s Base Sum Insured + accumulated No-Claim Bonus on the transferred coverage.

Example: If the previous plan had a Base of ₹10L and a Bonus of ₹5L, the total eligible transferred coverage is ₹15L. If the new Sum Insured chosen is ₹20L, then waiting period credits will apply up to ₹15L. The remaining ₹5 lakh will be treated as a fresh cover with new waiting periods.

It’s like carrying your old mobile data to a new plan. You can carry forward your existing usage history (waiting period credits) up to the amount of coverage you had before (Base + NCB). But if you increase your limit (buy more coverage), that extra portion is like new data that starts fresh with new rules (waiting periods).

What Are the Common Reasons for Health Insurance Portability?

Health insurance portability is especially appealing for several reasons:

1) Dissatisfaction with Your Current Insurer: 

If you’re facing poor customer service, unreasonably high premiums, or limited coverage, portability can help you find an insurer that meets your needs.

2) Improved Coverage: 

You might need higher coverage, extra benefits, or a broader network of hospitals. Porting lets you find a plan that better suits your evolving needs.

3) Cost-Effectiveness: 

If you can find a similar or even better plan at a more affordable price, portability can lead to significant savings.

4) Changing Needs: 

If your health situation, family size, or lifestyle changes, portability can help adjust your policy to match these new circumstances.

How to Port Your Existing Health Insurance Plan?

Here's how to ensure a smooth and successful transition:

1) Know the Right Time: 

You can port your policy only at the time of renewal. Ensure that you begin the process 45-60 days before your policy's renewal date.

2) Check Eligibility: 

• Retail Plans: Can be ported to a new insurer
• Group Insurance: Generally, it is not directly portable. Employer-provided plans cannot be ported, but group plans (e.g., those offered by banks) can typically be ported to retail plans through the insurer directly. 

To port, you should be in good health. For chronic conditions such as diabetes, hypertension, or heart issues, the new insurer may require medical tests or reject the porting request based on underwriting.

3) Review Your Current Policy: 

Make sure your current policy is in good standing and review its terms related to portability. The insurer you are switching to will need these details.

4) Select a New Insurer: 

Research other insurers based on factors like network hospitals, claim settlement ratio, incurred claim ratio, complaint volume, customer service, premiums, financial stability, and policy features.

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Are you unsure which insurer is right for you? Book a free call with a Ditto advisor and we’ll walk you through your options, explain what to watch out for, and help you make an informed choice.

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Step-by-Step Guide to Health Insurance Portability

Once you’ve selected your new insurer, here’s what the porting process looks like:

1) Submit your porting application

Provide the required documents (which we’ll cover in the next section). The insurer usually offers a portability form that the policyholder must fill out to smoothen the overall transition. Here’s HDFC ERGO’s portability form for your reference.

2) Await underwriting and approval

The new insurer will review your health declarations, medical records, and past claims. They may request a health check-up before issuing final approval.

3) Ensure a seamless transition

Once approved, coordinate with both insurers to ensure your new policy is issued promptly and that there’s no gap in coverage. In an ideal case, your agent/advisor will do this for you.

What Are the Documents Required to Port Your Existing Health Insurance?

You’ll need the following documents to port your health insurance policy:

1) Previous Policy Documents: 

This includes the policy number, issue date, renewal notice, and coverage details.

2) Claim History: 

• Any claims made under your previous policy. 
• Claim settlement letters
• Discharge documents.

3) Medical Records: 

Relevant medical reports, prescriptions, and test results, especially if you have pre-existing conditions.

4) ID Proof: 

Aadhaar card, PAN card, voter ID, or a driving license.

What Are the Rights of a Policyholder While Availing Health Insurance Portability?

IRDAI Guidelines: IRDAI states that portability allows health insurance policyholders (including all members under a family policy) to transfer benefits earned under one insurer to another insurer.

Here’s what they have to say about the following: 

1) Transferred Benefits

On porting, the policyholder is entitled to carry forward benefits such as:

• Sum Insured
• No Claim Bonus
• Waiting periods (specific conditions and pre-existing diseases)
• Moratorium period

2) Data Sharing Between Insurers

The existing and acquiring insurers must ensure seamless transfer of underwriting details and claim history.

The existing insurer must provide the requested information through the Insurance Information Bureau of India (IIB) portal (https://iib.gov.in/) within 72 hours of the request.

The acquiring insurer must decide and communicate its decision within 5 days of receiving the information.

3) Application Process

Policyholders must apply to the acquiring insurer to port the entire policy (including all family members, if covered) at least 30 days before and not earlier than 60 days before the renewal date.

Insurers may also consider applications made within 15 days of the renewal date; however, in such cases, the acquiring insurer must ensure that there is no break in coverage.

4) Charges

No additional charges shall be levied for porting either into or out of an insurer.

What Are the Reasons Your Health Insurance Portability Can Be Denied?

While portability is your right, insurers can deny a portability request under certain circumstances:

1) Health Conditions: 

If you have severe pre-existing conditions (like cancer or a serious heart ailment), your portability request may be denied, or you may be required to undergo a health check-up before approval.

2) Non-Disclosure: 

If the insurer finds that you've withheld critical information about your health history, this can also result in a rejected portability request.

Insurer's Perspective on Portability

It is fair to say that insurers are more cautious and risk-averse when it comes to portability. 

Why the Caution?

1) Adverse Selection Risk: 

Many portability applicants are people with medical histories or higher perceived risk. This makes the acquiring insurer wary of inheriting potential high-cost customers.

2) No Premiums Earned: 

The new insurer has not collected the policyholder’s past premiums. Yet, it may be required to provide immediate coverage (because waiting periods for pre-existing conditions and specific diseases are credited).

In effect, the previous insurer enjoyed the premiums during the waiting period years when there were no claims, while the new insurer inherits the liability without that benefit.

3) Detailed Scrutiny: 

To manage this imbalance, the acquiring insurer typically performs stricter underwriting, reviewing:

• Prior claim history
• Medical records and test reports
• Underwriting details shared by the existing insurer

4) Broader Strategy

Despite offering portability as required by regulation, many insurers view it as a compliance requirement rather than a growth engine. Their larger strategic aim is to expand the penetration of health insurance by attracting new, first-time customers rather than aggressively chasing those already insured by competitors.

This is also why many insurers restrict the latest plans available for porting. Their flagship or latest-generation products may be kept exclusive for fresh buyers. In such cases, you may only be offered access to a limited set of legacy or mass-market plans when porting your policy.

Ditto’s Take on Health Insurance Portability

At Ditto, we often get asked this question: “Should I port my health insurance policy?”

And here's our honest answer: not always.

Portability sounds excellent on paper. You will always find a cheaper plan, more benefits, or a better customer experience, and you're tempted to jump ship. But health insurance isn’t a gym membership, and switching without a good reason can actually do more harm than good, especially if you’ve already spent a few years building history with your current insurer.

Let’s break it down.

Porting Isn’t Just About Premiums

We’ve seen people port policies just to save ₹2,000-₹3,000 a year. And while saving money is great, health insurance isn’t the place to cut corners, especially if you’ve been with your current insurer for years.

By that point, you’ve likely built a strong relationship with your insurer:

• You’re nearing or may have already crossed the 5-year moratorium period, which means your insurer can’t reject claims based on non-disclosure (unless it’s proven fraudulent).
• You’ve paid premiums regularly, maybe even made claims. You’re now a loyal, low-risk customer in the eyes of your insurer.

P.S. - This is a favourable position to be in during claims.

Note: Porting does not reset the moratorium period. Let’s say you’re in your 4th policy year when you port, the new insurer must continue from where the old one left off. So, if you’ve already completed four years, you only have one year left until you’re fully protected under the moratorium clause. But there’s still a catch. With a new insurer, you’re under new scrutiny. Any minor mistake in your health declaration, such as forgetting to mention an old backache, can create problems. We’ve seen claims denied simply because of missing details that were innocently skipped during porting. So while the moratorium period continues from where you left off, you still need to go through the new insurer’s underwriting process, which can be more strict, especially if you’re older or have pre-existing conditions.

When You Shouldn’t Port

Here are scenarios where porting is usually not advisable:

• Your current insurer has a strong claims track record and above-average service. Instead of porting, you can migrate if you want to upgrade within the same insurer. 
  
  Migration allows you to switch to a different policy with the same insurer, maintaining continuity of benefits. This is perfect if you’re satisfied with your current insurer but need more comprehensive coverage.
• You’re in your 4th or 5th policy year and are about to cross (or have already crossed) the 5-year moratorium period.
• You haven’t faced major service issues: claims were paid, support was decent, and everything’s been smooth.

Note: You should avoid or reconsider porting if:

• You’re diagnosed with a critical illness like cancer, kidney failure, or heart disease; these are high-risk profiles that are commonly rejected during underwriting.
• If you are a senior citizen (typically over 65 years old), stricter underwriting and fewer plan options may apply.
• You have multiple pre-existing diseases (PEDs) or a complex medical history, which may lead to loadings, exclusions, or rejection.
• You are expected to be hospitalized soon or have a planned treatment, the new insurer might view this as an early claim risk and either reject the proposal or decline coverage for that treatment.

In short, if it ain’t broke, don’t fix it.

When Porting Might Make Sense

There are valid reasons to consider porting:

• Repeated claim hassles. If your claims are delayed, unfairly reduced, or denied.
• Very poor customer service, making it hard to get support when you need it most.
• Lack of coverage for your specific needs, like no maternity, room rent limits, or a low sum insured.
• Significant premium hikes with no improvement in benefits.

Even then, we recommend consulting with us or an expert to assess the risks. If you decide to port, you need to:

• Declare everything accurately (we cannot stress this enough).
• Understand what benefits carry forward and what new waiting periods apply. Suppose a new illness is diagnosed after purchase.

In that case, a fresh pre-existing disease waiting period (typically 3 years) may be applicable, especially if the ailment is not mentioned as a pre-existing condition in the previous insurer’s documentation. 

• Begin the process at least 45-60 days before renewal to avoid any gaps in coverage. It is recommended that you port at least 2 weeks in advance, as porting applications take longer than standard applications to be processed. 
• Ensure that the issued policy document clearly outlines your original policy issuance date and medical history details. Also, keep copies of proposal forms, policy documents, and all agent/insurer communications for both insurers.

Our Recommendation in Most Cases

Port only if there's a strong, valid reason. Not just because something “seems” better on paper. We’ve seen long-time policyholders encounter unnecessary claim issues simply because they switched to slightly better benefits. That ₹2,000 saved on premiums? It’s not worth a ₹2 lakh denied claim.

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Conclusion

Health insurance portability can be a great way to find a more suitable insurance plan without losing the benefits you've already earned. However, it’s essential to carefully weigh the pros and cons, thoroughly consider the new insurer, and understand all the terms involved. 

You should avoid knee-jerk decisions. Do not decide on porting based on a single piece of negative news, a nasty tweet, or an isolated review. Every insurer will have thousands of such complaints or opinions online. It doesn’t necessarily reflect the insurer’s overall performance.

Instead, you should focus on real factors. Evaluate portability based on product suitability, long-term service experience, claim settlement records, network coverage, and premium affordability.

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